Broad goals and specific aims: Kentucky ranks among the worst in the nation for its burdens of diabetes (41st ) and obesity (46th), which are major contributors to the fact that Kentucky ranks 44th for its all-cause mortality rate. The proposed Kentucky Diabetes and Obesity Collaborative (KDOC) represents a transformative initiative to develop a novel and sustainable research infrastructure designed for the long-term goals of mitigating the public health burdens of obesity and diabetes in a rural medically underserved population and generating new knowledge applicable to similar populations. KDOC partners will include a network of rural primary care providers, Public Health Departments, Kentucky Medicaid and key units of the University of Kentucky Academic Health Center (UK AHC). This three year infrastructure- building project will has these specific aims: Specific Aim 1: Engage the partners listed above to collaboratively develop the proposed research infrastructure and define mutual research priorities and training needs related to its use Specific Aim 2: Develop, test and refine new web-based informatics tools to facilitate translational research and disease management across the KDOC network Specific Aim 3: Develop, implement and evaluate training of AHC-community partners for effective research collaborations congruent with KDOC goals Methods: The project will create a partnership linking 10 rural Federally-Qualified Community Health Centers, 6 Public Health Department Diabetes Centers of Excellence, Kentucky Medicaid and the UK AHC to form the KDOC infrastructure. Funding, project input, and responsibilities will be shared across the partners. Information technologies will support KDOC operations;including a new web-based patient clinical data registry linked to Medicaid claims data and a web-based suite of tools for research communications, protocol management and training. Training needs of users of the infrastructure will be assessed via focus groups and key informants, then addressed using in-person and distance- learning techniques. Regular KDOC project personnel visits to partner sites, tele-video meetings, annual KDOC conferences, a 'flat'governing structure and marketing of the research infrastructure to potential users will be used to assure its utility and productive use. The UK Center for Clinical and Translational Science and the UK Center for Public Health Services and Systems Research will provide extensive support and expertise for development and use of KDOC. PUBLIC HEALTH RELEVANCE: Obesity and diabetes cause enormous burdens of disease in Kentucky and many other rural states, where they pose major threats to public health and strain the capacity of healthcare systems. This project aims to develop new University-Community partnerships for research that will lead to reductions in the burdens of obesity, diabetes and their complications among rural Kentuckians, and generate new knowledge applicable to other medically underserved populations.